Evaluation of reflux, functional dyspepsia and irritable bowel syndrome symptoms in patients with chronic kidney disease

Objective: The aim of this study was to evaluate the prevalence of gastroesophageal reflux disease (GERD), functional dyspepsia (FD) and irritable bowel syndrome (IBS) symptoms in patients with chronic kidney disease (CKD) who are receiving and not receiving hemodialysis (HD) compared to healthy volunteers and to evaluate the relationship of these symptoms with depression, anxiety and quality of life. Materials and Methods: A total of 150 participants were enrolled from the Internal Medicine and Nephrology outpatient clinics at Manisa Celal Bayar University. The study included 50 healthy controls, 50 CKD patients not receiving HD, and 50 HD patients. Participants were adults aged 18 years or older, diagnosed with stage 3-5 CKD, and, for HD patients, had been undergoing dialysis for at least three months. Gastrointestinal symptoms were assessed using the Rome IV criteria, while depression and anxiety were evaluated with the Hospital Anxiety and Depression Scale (HADS), and quality of life was measured using the Short Form-12 (SF-12). Data were collected through clinical examinations, laboratory tests, and self-reported questionnaires. Statistical analyses were performed using SPSS version 21.0, with a p-value <0.05 considered statistically significant. The study was conducted in accordance with the Declaration of Helsinki. Results: The prevalence of constipation-predominant irritable bowel syndrome (IBS-C) was significantly higher in HD patients (28%) compared to the control (12%) and CKD (14%) groups (p=0.038). No significant differences were observed in the prevalence of GERD or FD. Patients with postprandial distress syndrome (PDS) and IBS-C exhibited significantly higher depression and anxiety scores (p<0.05) and lower physical and mental quality of life (p<0.05). Quality of life in HD patients was significantly lower than in controls (p<0.001). Conclusion: The study demonstrated a higher prevalence of IBS-C in HD patients, with these symptoms adversely affecting mental health and quality of life. The findings highlight the need for increased attention to gastrointestinal complaints in clinical assessments. The limited sample size and reliance on self-reported questionnaires may restrict generalizability; larger, objective, and longitudinal studies are needed to elucidate the etiology of these symptoms. Keywords: Chronic Kidney Disease, Hemodialysis, Irritable Bowel Syndrome, Functional Dyspepsia, Gastroesophageal Reflux, Quality of Life